Drug interactions
Natalizumab + Ocrelizumab
Severity: Major
Natalizumab and Ocrelizumab: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ocrelizumab depletes B cells and natalizumab restricts lymphocyte trafficking. Used together or in close sequence, they can increase infection risk, including PML.
What this interaction means in plain words
Natalizumab and Ocrelizumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Natalizumab belongs to Gastrointestinal Tract; Ocrelizumab belongs to Central Nervous System.
Why it happens
Additive immunosuppression via B-cell depletion and integrin-mediated lymphocyte trafficking blockade.
What to do
Avoid concurrent use. When switching, follow PML risk assessment including baseline MRI and monitor for infection.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Natalizumab
- Natalizumab + Vedolizumab Contraindicated
- Axicabtagene ciloleucel + Natalizumab Major
- Baricitinib + Natalizumab Major
- Belatacept + Natalizumab Major
- Brexucabtagene autoleucel + Natalizumab Major
- Cabazitaxel + Natalizumab Major
Other interactions of Ocrelizumab
- Adenovirus types 4 and 7 live + Ocrelizumab Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Ocrelizumab Contraindicated
- Measles mumps and rubella vaccine live + Ocrelizumab Contraindicated
- Measles mumps rubella and varicella vaccine live + Ocrelizumab Contraindicated
- Measles vaccine + Ocrelizumab Contraindicated
- Anti-thymocyte + Ocrelizumab Major
Frequently asked questions
Can I take Natalizumab with Ocrelizumab?
MediHelp rates the interaction as major. Natalizumab and Ocrelizumab can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ocrelizumab depletes B cells and natalizumab restricts lymphocyte trafficking. Used together or in close sequence, they can increase infection risk, including PML.
How serious is the interaction between Natalizumab and Ocrelizumab?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use. When switching, follow PML risk assessment including baseline MRI and monitor for infection.
What other medicines interact with Natalizumab?
MediHelp also lists interactions of Natalizumab with, for example, Vedolizumab, Axicabtagene ciloleucel, Baricitinib. The full list is on the Natalizumab page.
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